Awareness of Cancer Screening During Treatment of Patients with Renal Failure: A Physician Survey in Turkey

Uysal-Sonmez, Ozlem,Tanriverdi, Ozgur,Uyeturk, Ummugul,Budakoglu, Isil Irem,Kazancioglu, Rumeyza,Turker, Ibrahim,Budakoglu, Burcin,Yalcintas-Arslan, Ulku,Oksuzoglu, Berna Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.5

Background: Today, survival rate of patients with chronic renal failure/hemodialysis has increased so that chronic illnesses are more likely to occur. Cancer is the main cause of morbidity and mortality in such patients. Aim: In this study, physician attitudes were examined about cancer screening in patients with renal failure. Materials and Methods: This study was done by face to face questionnaire in the $27^{th}$ National Nephrology Congress to determine if the physicians dealing with chronic renal failure, hemodialysis or renal transplanted patients, recommend cancer screening or not and the methods of screening for cervix, prostate, breast and colon cancer. Results: One hundred and fifty six physicians were included in the survey. A total of 105 (67%) participants were male and the age of responders was $48{\pm}9$ years. About 29% were specialists in nephrology, 28% internal medicine, and 5% were other areas of expertise. Some 48% of participants were hemodialysis certified general practitioners. Patients were grouped as compensated chronic renal failure, hemodialysis or renal transplanted. Of the 156 responders, 128 (82%) physicians recommended breast cancer screening and the most recommended subgroup was hemodialysis patients (15%). The most preferred methods of screening were combinations of mammography, self breast examination and physicianbreast examination. 112 (72%) physicians recommended cervix cancer screening, and the most preferred method of screening was pap-smear. Colon cancer screening was recommended by 102 (65%) physicians and prostate screening by 109 (70%) physicians. The most preferred methods of screening were fecal occult blood test and PSA plus rectal digital test, respectively. Conclusions: It is not obvious whether cancer screening in renal failure patients is different from the rest of society. There is a variety of screening methods. An answer can be found to these questions as a result of studies by a common follow-up protocol and cooperation of nephrologists and oncologists.

Multicenter Evaluation of Patients with Cutaneous Malignant Melanoma in Turkey: MELAS Study

Uysal-Sonmez, Ozlem,Tanriverdi, Ozgur,Esbah, Onur,Uyeturk, Ummugul,Helvaci, Kaan,Bal, Oznur,Yalcintas-Arslan, Ulku,Budakoglu, Burcin,Oksuzoglu, Berna Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.1

Background: Malignant melanoma is a cancer that demonstrates rapid progression and atypical clinically features with a poor prognosis. Aim: This study was performed to determine the clinical characteristics and treatment outcomes of patients with malignant melanoma in Turkey. Methods: The medical records of 98 patients between 2007-2012 at our centers were retrieved from the patient registry. Overall survival (OS) was calculated using the Kaplan-Meier method. Results: In our study, with the median follow-up of all patients with cutaneous MM of 46.3 months, the median OS rate of all cases was 43.6 months and 5-year OS was 48.6%. However, five-year OS rates of patients with localized disease (stage I-II) and node involvement (stage III) were 60.3% and 39.6%, respectively. The median OS of stage IV patients was 8.7 months and 1-year OS rate was 26.2%. We showed that advanced stage, male gender, and advanced age in all patients with MM were significant prognostic factors of OS. Conclusions: Compared with the results of current studies from Western countries, we found similar findings concerning demographical features, histological variables and survival analyses for our patients with cutaneous MM in Turkey.

Which One is More Effective, Filgrastim or Lenograstim, During Febrile Neutropenia Attack in Hospitalized Patients with Solid Tumors?

Sonmez, Ozlem Uysal,Guclu, Ertugrul,Uyeturk, Ummugul,Esbah, Onur,Turker, Ibrahim,Bal, Oznur,Budakoglu, Burcin,Arslan, Ulku Yalcintas,Karabay, Oguz,Oksuzoglu, Berna Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.3

Background: Chemotherapy-induced febrile neutropenia (FN) with solid tumors causes mortality and morbidity at a significant rate. The purpose of this study was to compare the effects of filgastrim and lenograstim started with the first dose of antibiotics in hospitalized patients diagnosed with FN. Materials and Methods: Between February 2009 and May 2012, 151 patients diagnosed with FN were evaluated, retrospectively. In those considered appropriate for hospitalization, convenient antibiotic therapy with granulocyte colony stimulating factors was started within first 30 minutes by completing necessary examinations in accordance with FEN guide recommendations. Results: In this study, 175 febrile neutropenia attacks in 151 patients were examined. Seventy three of the patients were male and 78 were female. The average age was 53.6 and 53.6, respectively. The most common solid tumor was breast carcinoma in 38 (25%). One hundred and five FN patients (58%) were those who received granulocyte colony stimulating factors as primary prophylaxis. Conclusions: While studies comparing both drugs generally involve treatments started for prophylaxis, this study compared the treatment given during the febrile neutropenia attack. Compared to lenograstim, filgastrim shortens the duration of hospitalization during febrile neutropenia attack by facilitating faster recovery with solid tumors.

Gastric Carcinoma with Bone Marrow Metastasis: A Case Series

Ekinci, Ahmet Siyar,Bal, Oznur,Ozatli, Tahsin,Turker, Ibrahim,Esbah, Onur,Demirci, Ayse,Budakoglu, Burcin,Arslan, Ulku Yalcintas,Eraslan, Emrah,Oksuzoglu, Berna The Korean Gastric Cancer Association 2014 Journal of gastric cancer Vol.14 No.1

Gastric cancer is a major cause of cancer-related mortality. At the time of diagnosis, majority of the patients usually have unresectable or metastatic disease. The most common sites of metastases are the liver and the peritoneum, but in the advanced stages, there may be metastases to any region of the body. Bone marrow is an important metastatic site for solid tumors, and the prognosis in such cases is poor. In gastric cancer cases, bone marrow metastasis is usually observed in younger patients and in those with poorly differentiated tumors. Prognosis is worsened owing to the poor histomorphology as well as the occurrence of pancytopenia. The effect of standard chemotherapy is unknown, as survival is limited to a few weeks. This report aimed to evaluate 5 gastric cancer patients with bone marrow metastases to emphasize the importance of this condition.

Metaplastic Breast Carcinoma: Case Series and Review of the Literature

Esbah, Onur,Turkoz, Fatma P.,Turker, Ibrahim,Durnali, Ayse,Ekinci, Ahmet S.,Bal, Oznur,Sonmez, Ozlem Uysal,Budakoglu, Burcin,Arslan, Ulku Y.,Oksuzoglu, Berna Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.9

Metaplastic breast carcinoma (MpBC) is a rare disease entity, accounting for less than 1% of all breast carcinomas. Furthermore, it is a heterogenous disease with different subgroups, including malignant epithelial (carcinoma) and stromal (sarcoma) features. Here we evaluated, retrospectively, 14 female MpBC patients admitted to Ankara Oncology Training and Research Hospital between 2005 and 2011. Median age was 45.5 (range:16.0-76.0) and tumor size 57.5 mm (range: 20.0-80.0 mm). Histopathological subtypes were as follows: 5 carcinosarcoma, 5 squamous and 4 adenosquamous carcinoma. All but one with upfront lung metastasis, had their primary breast tumor operated. Axillary lymph nodes were involved in 64.3%. The most common sites of metastasis were lungs and brain. Chemotherapy including antracycline, taxane and even platinium was planned for adjuvant, neoadjuvant and palliative purposes in 9, 3 and 1 patient, respectively. Median cycles of chemotherapy was 6 (range:4-8). Median follow-up of the patients was 52 months (95%CI 10.4-93.6 month). Median 3 year progression free survival (PFS) and overall survival (OS) in this patients cohort were 33% and 56%, respectively. In conclusion, MpBC is a rare and orphan disease without standardized treatment approaches and the prognosis is poor so that larger studies to investigate different treatment schedules are urgently needed.

Detection of Circulating Tumor Cells in Breast Cancer Patients: Prognostic Predictive Role

Turker, Ibrahim,Uyeturk, Ummugul,Sonmez, Ozlem Uysal,Oksuzoglu, Berna,Helvaci, Kaan,Arslan, Ulku Yalcintas,Budakoglu, Burcin,Alkis, Necati,Aksoy, Sercan,Zengin, Nurullah Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.3

A determination of circulating tumor cell (CTC) effectiveness for prediction of progression-free survival (PFS) and overall survival (OS) was conducted as an adjunct to standard treatment of care in breast cancer management. Between November 2008 and March 2009, 22 metastatic and 12 early stage breast carcinoma patients, admitted to Ankara Oncology Training and Research Hospital, were included in this prospective trial. Patients' characteristics, treatment schedules and survival data were evaluated. CTC was detected twice by CellSearch method before and 9-12 weeks after the initiation of chemotherapy. A cut-off value equal or greater than 5 cells per 7.5 ml blood sample was considered positive. All patients were female. Median ages were 48.0 (range: 29-65) and 52.5 (range: 35-66) in early stage and metastatic subgroups, respectively. CTC was positive in 3 (13.6%) patients before chemotherapy and 6 (27.3%) patients during chemotherapy in the metastatic subgroup whereas positive in only one patient in the early stage subgroup before and during chemotherapy. The median follow-up was 22.0 (range: 21-23) and 19.0 (range: 5-23) months in the early stage and metastatic groups, respectively. In the metastatic group, both median PFS and OS were significantly shorter in any time CTC positive patients compared to CTC negative patients (PFS: 4.0 vs 14.0 months, Log-Rank p=0.013; and OS: 8.0 months vs. 20.5 months, Log-Rank p<0.001). OS was affected from multiple visceral metastatic sites (p=0.055) and higher grade (p=0.044) besides CTC positivity (log rank p<0.001). Radiological response of chemotherapy was also correlated with better survival (p<0.001). As a result, CTC positivity was confirmed as a prospective marker even in a small patient population, in this single center study. Measurement of CTC by CellSearch method in metastatic breast carcinoma cases may allow indications of early risk of relapse or death with even as few as two measurements during a chemotherapy program, but this finding should be confirmed with prospective trials in larger study populations.

Predictors of Outcome in Patients with Advanced Nonseminomatous Germ Cell Testicular Tumors

Yetisyigit, Tarkan,Babacan, Nalan,Urun, Yuksel,Seber, Erdogan Selcuk,Cihan, Sener,Arpaci, Erkan,Yildirim, Nuriye,Aksoy, Sercan,Budakoglu, Burcin,Zengin, Nurullah,Oksuzoglu, Berna,Yalcin, Banu Cicek,Al Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.2

Background: Predictor factors determining complete response to treatment are still not clearly defined. We aimed to evaluate clinicopathological features, risk factors, treatment responses, and survival analysis of patient with advanced nonseminomatous GCTs (NSGCTs). Materials and Methods: Between November 1999 and September 2011, 140 patients with stage II and III NSGCTs were referred to our institutions and 125 patients with complete clinical data were included in this retrospective study. Four cycles of BEP regimen were applied as a first-line treatment. Salvage chemotherapy and/or high-dose chemotherapy (HDCT) with autologous stem cell transplantation were given in patients who progressed after BEP chemotherapy. Post-chemotherapy surgery was performed in selected patients with incomplete radiographic response and normal tumor markers. Results: The median age was 28 years. For the good, intermediate and poor risk groups, compete response rates (CRR) were, 84.6%, 67.9% and 59.4%, respectively. Extragonadal tumors, stage 3 disease, intermediate and poor risk factors, rete testis invasion were associated with worse outcomes. There were 32 patients (25.6%) with non-CR who were treated with salvage treatment. Thirty-one patients died from GCTs and 94% of them had stage III disease. Conclusions: Even though response rates are high, some patients with GCTs still need salvage treatment and cure cannot be achieved. Non-complete response to platinium-based first-line treatment is a negative prognostic factor. Our study confirmed the need for a prognostic and predictive model and more effective salvage approaches.

Rare earth elements (REEs) investigation of fly ash placers in southwestern Taurides: footprints of alkaline potassic Gölcük volcanism, Turkey

Ali Tugcan Unluer,Zeynep Doner,Mustafa Kaya,Huseyin Kocaturk,Amr Abdelnasser,Mustafa Kumral,Murat Budakoglu,Mehmet Sezai Kirikoglu 한국지질과학협의회 2023 Geosciences Journal Vol.27 No.4

The importance of Rare Earth Elements (REE) is consistently rising for industrialized countries due to their widespread usage in various applications. Production of REE heavily relies on carbonatite-ijolite complexes and other alkaline magmatic products. With this perspective, the potassic-alkaline volcanism related fly ash placers in Burdur and Isparta regions (SW, Turkey) are considered as a valuable prospecting target for REE. This work primarily focuses on the REE enrichment features (geochemistry, mineralogy, provenance and alteration processes) of Burdur and Isparta fly ash placers for construing the REE behaviour. At last, formation modeling of studied deposits was established and the similarities between studied deposits and some World class REE deposits were presented. Main REE-bearing minerals of studied deposits were identified as chevkinite, britholite and fluorapatite with considerable amounts of LREE as well as Th, Fe and Ti. The geochemical analysis results show that most of ΣREE values (up to 1109 and 1233 ppm, respectively) were comprised by La, Ce, Nd and Pr elements. The smaller grain size is a key factor in REE enrichment by the effectof combined factors such as REE-bearing mineral’s average crystal size, distribution, and higher intensity weathering process. The interference of Ca from meta-sedimentary carbonate rocks have a negative effect on REE accumulation. Because of the good response for ore purification methods and promising results for some of the critical REE, Burdur and Isparta fly ash placers might be feasible in the future in case of tighter supply and increasing global demand.